慢性胰腺炎的外科治疗及术式评价  

The surgical managements for chronic pancreatitis and the evaluation of the procedures

作　　者：杨尹默[1] 马永蔌[1] 高红桥[1] 庄岩[1] 

机构地区：[1]北京大学第一医院普通外科,北京100034

出　　处：《中国实用外科杂志》2011年第9期788-791,共4页Chinese Journal of Practical Surgery

摘　　要：慢性胰腺炎的典型临床特征为持续性不可逆的炎症过程、反复发作的疼痛症状和进行性丧失的胰腺内分泌与外分泌功能。其病理学改变包括胰腺实质的纤维化、胰腺导管的解剖性狭窄与扩张、可并发胰腺实质的钙化或胰管结石等。酗酒是慢性胰腺炎最常见的病因。评价慢性胰腺炎外科治疗效果的标准是临床症状的缓解程度,术式包括引流手术(Peustow手术,Partington and Rochelle手术等)、不同范围的胰腺切除手术以及上述两种术式的联合(Beger手术,Frey手术等)。由于慢性胰腺炎的临床症状、病理学改变及影像学表现的复杂性,治疗上不可一概而论,更不可随意而为,在选择内科、内镜或外科特别是外科何种术式做为病人治疗的途径时,应对上述方式有非常清楚的理解,个体化应用,使病人最大获益。Chronic pancreatitis is usually eharaclerised by a persistent intlammtol process, recurrent painfld attacks and progressive loss of pancreatic endncrine and exoerine funetion. Its palhologieal change eneludes fibrosis of the parenehyma, anatomic stricture and dilatation of the pancreatic duet, with or without calcification or slune. It is most commonly caused hy the abuse of alcohol. The evaluation criterion for a successful treatrnent is the degree of symptomatic relief. The surgical management aimed at the pancrease includes simple drainage procedures （Peustow procedure, Partinglon and Roe, helle procedure, el al）, reseclions of dill〉rent extents combination of both （Beger procedure, Frey procedure, el al ）. For the complexity of the symptumalology, pathology and radiology, the managements wouhl be diversified. Whelher surgery, endulherapy or other modalities are applied, individualization according to the surgical indications shuuhl be kept in mind.

关 键 词：慢性胰腺炎 外科治疗 内镜治疗 个体化 

分 类 号：R6[医药卫生—外科学]